RESUMO
OBJECTIVE: To identify body mass index (BMI) trajectories from birth to age 10 years and to assess their association with child and parental characteristics and with adult nutritional status and metabolic risk factors. STUDY DESIGN: Retrospective cohort study with 1188 subjects aged 20-60 years. Childhood growth was assessed using measured weight and height data collected retrospectively from health booklets, which also provided information on gestational age, birth weight, and early nutrition. Height, weight, waist circumference, fasting blood glucose, lipids profile, and blood pressure were measured at adulthood. Participants self-reported parental silhouette based on a 9-figural scale. Group-based modeling was applied to identify BMI trajectories. Associations were assessed using ANOVA and multiple logistic regression. RESULTS: Five growth trajectories following or crossing BMI percentiles emerged: stable-25th (15.3% of the sample), stable-50th (35.9%), stable-75th (28.0%), ascending-75th (19.2%), and ascending-obesity (1.6%). Overall, associated factors from early life were mother's corpulence (higher in the ascending-obesity group), gestational age (higher in the stable-50th, stable-75th, and in the ascending-obesity groups), and birth weight (higher in the ascending-obesity group) (all P < .05). Childhood trajectories were associated with adult BMI and waist circumference (higher in the stable-75th and in the ascending groups) (all P < .0001). CONCLUSIONS: This study shows heterogeneity in patterns of growth trajectories. Specific trajectories were associated with greater BMI and waist circumference during adulthood. Monitoring growth trajectories may improve chronic disease prevention.
Assuntos
Índice de Massa Corporal , Doenças Cardiovasculares/etiologia , Desenvolvimento Infantil/fisiologia , Adulto , Glicemia/metabolismo , Pressão Sanguínea/fisiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Estudos Retrospectivos , Fatores de Risco , Aumento de Peso , Adulto JovemRESUMO
OBJECTIVE: To examine the association between breastfeeding and adult body fatness, adjusting for nutritional intake in early childhood. STUDY DESIGN: Nutritional intakes of 73 healthy infants born in 1984 who participated in the 2-decade-long Longitudinal Study of Nutrition and Growth in Children (Etude Longitudinale Alimentation Nutrition Croissance des Enfants [ELANCE]) were estimated at age 10 months and again at age 2 years. Breastfeeding was defined as any breastfeeding, including partial breastfeeding, regardless of duration. At age 20 years, weight, height, subscapular skinfold thickness (SF), and fat mass (assessed via bioelectrical impedance analysis) were measured. RESULTS: In this sample, 64% of the children had been breastfed. In linear regression models adjusted for mother's body mass index and father's profession, breastfeeding was not associated with any of the body fat measurements at 20 years (all P > .05). After adding nutritional intake variables (total energy and % energy from nutrients) to the models, breastfeeding became significantly associated with lower SF at 20 years. In particular, breastfed subjects had significantly lower % SF at 20 years after adjustment for energy and % fat intakes at 2 years of age, (ß = -28.25% SF; 95% CI, -50.28% to -6.21%; P = .013) or when adjusting for energy and % carbohydrates at 2 years of age (ß = -28.27% SF; 95% CI, -50.64% to -5.90%; P = .014). CONCLUSION: Breastfeeding was not associated with adult body fatness taking into account the usual confounding factors. However, after also adjusting for nutritional intake covariates, a protective effect of breastfeeding emerged. Early nutrition needs to be taken into account when examining the long-term health effects of breastfeeding.
Assuntos
Tecido Adiposo/metabolismo , Índice de Massa Corporal , Aleitamento Materno , Obesidade/epidemiologia , Adulto , Fatores Etários , Pré-Escolar , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Estado Nutricional , Obesidade/prevenção & controle , Medição de Risco , Sensibilidade e Especificidade , Fatores Sexuais , Dobras CutâneasRESUMO
OBJECTIVE: To identify anthropometric and behavioral characteristics associated with weight maintenance after an obesity treatment. STUDY DESIGN: Adolescents (n = 72) enrolled in a 9-month obesity treatment were observed 1 and 2 years after discharge. Two groups, "successful" versus "limited or no success," were created on the basis of the differences in body mass index (BMI) z-score between inclusion and end of follow-up. Anthropometric and behavioral characteristics were compared between groups. RESULTS: Both groups showed a decrease in BMI z-score between inclusion and end of follow-up, 2.09 +/- 0.68 SD for the successful group and 0.65 +/- 0.43 SD for the group with limited or no success. Groups did not differ during treatment for any of the anthropometric characteristics considered, whereas differences clearly appeared 1 year after treatment and generally stabilized during the second year. Later adiposity rebound, trend for lower BMI in the mother, and, during follow-up, lower total energy intake, more energy at breakfast, and less snacking and television were recorded in the successful group. CONCLUSIONS: Weight loss maintenance can neither be predicted with anthropometry during treatment nor with behavioral characteristics at inclusion, but can be estimated 1 year after discharge. Early life factors should also be taken into account for predicting treatment outcome.
Assuntos
Pesos e Medidas Corporais , Exercício Físico , Comportamento Alimentar , Comportamentos Relacionados com a Saúde , Obesidade/fisiopatologia , Obesidade/psicologia , Adolescente , Antropometria , Criança , Ingestão de Energia , Feminino , Seguimentos , Humanos , Masculino , Obesidade/terapia , Fatores de TempoRESUMO
OBJETIVO: Avaliar o estado nutricional de crianças de sete a nove anos de idade de Florianópolis (Brasil) e comparar a prevalência de sobrepeso e baixo peso com um estudo realizado na França. MÉTODOS: Os dois estudos comparados consistiram em investigações transversais de amostras aleatórias estratificadas de crianças de sete a nove anos da idade (Florianópolis, n= 2.232 ; França, n= 1.582) , delineados com base no protocolo recomendado pelo European Childhood Obesity Group. As medidas antropométricas (peso e estatura) foram coletadas de acordo com normas recomendadas pela Organização Mundial de Saúde. Na análise da prevalência de sobrepeso e baixo peso (magreza) usou-se a referência francesa. Compararam-se alguns fatores relacionados à prática de atividade física e comportamentos sedentários entre os dois estudos. RESULTADOS: As crianças de Florianópolis foram mais altas e apresentaram maior peso corporal que as francesas. A prevalência de baixo peso foi mais baixa em Florianópolis, comparando-se com a França (1.1 vs 3.9%). A prevalência de sobrepeso foi de 19,9% em Florianópolis e de 16,3% na França. Certos tipos de comportamentos podem estar contribuindo para uma mais elevada prevalência de sobrepeso em Florianópolis, quando comparada à França. As crianças francesas apresentaram mais elevado nível de atividade física: 66,5% das crianças franceses realizavam atividade esportiva regular, quando comparados aos 35,7% das crianças de Florianópolis. Na França, o tempo destinado a assistir televisão, jogar vídeo game e utilizar computador foi de duas horas por dia, enquanto no Brasil foi de 3,3 horas diárias. CONCLUSÃO: Alguns fatores comportamentais, tais como nível de atividade física, e sedentarismo podem explicar as diferenças encontradas. As estratégias visando à redução da prevalência do sobrepeso infantil devem levar em consideração as particularidades específicas de cada país.